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前瞻性临床研究乙型肝炎疫苗接种用于血液系统恶性肿瘤患儿:安全性和免疫原性疗效研究。

Prospective clinical trial of hepatitis B vaccination for children with hematological malignancies: a study on the safety and immunogenicity efficacy.

机构信息

Department of Immunology, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China.

Department of Hematology and Oncology, Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.

出版信息

Hum Vaccin Immunother. 2021 Nov 2;17(11):4578-4586. doi: 10.1080/21645515.2021.1953303. Epub 2021 Aug 17.

Abstract

Children with hematological malignancies are at increased risk of hepatitis B virus infection. This study assessed the immunogenicity and safety profile of HBV vaccination in pediatric hemato-oncological children. A nonrandomized interventional study was conducted from January 2017 to February 2020 in Shanghai, China. Seventy-three pediatric hemato-oncological children with hepatitis B surface antibody (anti-HBs) titers <10 mIU/ml were recruited. The participants received three doses of recombinant HBV vaccine according to the 0-, 1-, and 6- month immunization schedule. Adverse events following immunization and anti-HBs titers (at baseline, 1 month, and 6 months after inoculation) were recorded. Forty-three males and thirty females with median ages of 9.12 and 9.60 years, respectively, were included. The mean anti-HBs titer was 4.88 ± 2.61 mIU/ml, 893.12 ± 274.12 mIU/ml, and 711.45 ± 337.88 mIU/ml at baseline, one month, and six months after inoculation, respectively (< .001). A total of fourteen adverse events following immunization were reported, and among them, 5 (6.85%), 5 (6.85%), and 4 (5.48%) events were reported after the first, second, and third inoculation, respectively (= .927). In conclusions, the HBV vaccine is immunogenic and safe in children with hematological malignancies. It is worth noting that the anti-HBs titer was decreased at the 6-month follow-up, and periodic monitoring of the anti-HBs titer accompanied by timely booster vaccination should be carefully considered. AEFI: Adverse events following immunization; HBV: Hepatitis B virus; Anti-HBs: Antibody against hepatitis B surface antigen; HBsAg: Hepatitis B surface antigen; APC: Antigen-presenting cell; HSCT: Hemopoietic stem cell transplantation; COVID-19: Corona Virus Disease 2019.

摘要

患有血液系统恶性肿瘤的儿童感染乙型肝炎病毒的风险增加。本研究评估了乙型肝炎病毒疫苗在儿科血液肿瘤儿童中的免疫原性和安全性。这是一项 2017 年 1 月至 2020 年 2 月在中国上海进行的非随机干预性研究。共招募了 73 名乙型肝炎表面抗体(抗-HBs)滴度<10 mIU/ml 的儿科血液肿瘤患儿。参与者按照 0、1 和 6 个月的免疫接种计划接种了三剂重组乙型肝炎病毒疫苗。记录接种后的不良反应事件和抗-HBs 滴度(接种前、接种后 1 个月和 6 个月)。纳入的 43 名男性和 30 名女性的中位年龄分别为 9.12 岁和 9.60 岁。接种前、接种后 1 个月和 6 个月的平均抗-HBs 滴度分别为 4.88±2.61 mIU/ml、893.12±274.12 mIU/ml 和 711.45±337.88 mIU/ml(<.001)。共报告了 14 例接种后不良反应事件,其中第 1、2 和 3 次接种后分别报告了 5(6.85%)、5(6.85%)和 4(5.48%)事件(=0.927)。总之,乙型肝炎病毒疫苗在血液系统恶性肿瘤儿童中具有免疫原性和安全性。值得注意的是,在 6 个月的随访中抗-HBs 滴度下降,应仔细考虑定期监测抗-HBs 滴度并及时进行加强免疫接种。AEFI:接种后不良反应事件;HBV:乙型肝炎病毒;Anti-HBs:乙型肝炎表面抗体抗体;HBsAg:乙型肝炎表面抗原;APC:抗原呈递细胞;HSCT:造血干细胞移植;COVID-19:2019 年冠状病毒病。

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